3 admissions information Today s Date Social Security Number Name Other name which may appear on transcripts: Date of Birth (MM/DD/YYYY) First Middle Last/Family U.S. Address Number and Street Apartment No. City State Zip Code Home Phone Cell Phone Address Emergency Contact Relationship Phone Number ( ) Have you ever been convicted of a felony? q Yes q No If yes, please attach a description outlining the type of offense, the circumstances of the offense, and the date you were convicted. Do you have any pending charges? q Yes q No If yes, please provide the following in a typed document: type of offense, circumstances, date, county, state and jurisdiction of the offense. Expected Entrance Term q Fall I q Fall II q Spring I q Spring II q Summer I q Summer II Expected Entrance Year q 2012 q 2013 Initial Status q New Student q Transfer q Return After One Year q Re-Entry (Graduate of WU) q Certification Only q Continuing Education (non degree-seeking) Enrollment Type q Full-Time q Part-Time Previously Applied q Yes q No Previously Attended q Yes q No Access Location DELAWARE q Wilson Graduate Center q Brandywine q Dover q Dover Air Force Base q Georgetown q Middletown NEW JERSEY q Burlington County College q Cumberland County College q Joint Base McGuire-Dix-Lakehurst MARYLAND q Aberdeen Proving Ground q Cecil College q Online Attendance Type q Day q Evening q Day and Evening q Online q Other: Gender q Male q Female Military Status q Active Duty q National Guard q Reserves q Veteran q Not Applicable Military Branch q Air Force q Army q Coast Guard q Marine Corps q Navy Employment Status q Full-Time q Part-Time q Self-Employed q Unemployed q Other: Ethnicity q Hispanic of any race q Nonresident Alien For Non-Hispanics Only q American Indian or Alaskan Native q Asian q Black or African American q Native Hawaiian or Other Pacific Islander q White q Two or more races q Race & Ethnicity Unknown Are you a citizen of the United States? q Yes q No If No, complete the information below. Residency Status q Permanent Resident/Green Card Holder (submit copy) All International Students must comply with the Bureau of Citizenship and Immigration Services regulations. Please contact the International Student Contact at the Wilson Graduate Center for a complete listing of all materials required for International Student Admissions. Country of Citizenship International Address Country of Birth

4 Will you require an F-1 visa to study at Wilmington University? q Yes q No Are you transferring from another college in the United States? q Yes q No What type of visa do you have? q F-1 (Student in Academic Program) q H-4 (Spouse or Child of H-1) q R-1 (Religious Worker) q F-2 (Spouse or Child of F-1) q A-1 (Ambassador Diplomat or Immediate Family) q R-2 (Spouse or Child of R-1) q J-1 (Exchange Student) q A-2 (Foreign Government Official or Immediate Family) q Other q H-1 (Temporary Worker) q B-2 (Business Visitor) Do you plan to apply for Financial Aid? q Yes q No If yes, please visit for Financial Aid support and planning. previous academic information List all colleges/universities previously attended. List undergraduate experience first, then graduate. Please list professional schools and certifications last. Please have official transcripts from all institutions listed below forwarded directly from the school to Wilmington University INSTITUTION CITY/STATE DATES ATTENDED CREDITS EARNED DEGREE EARNED Acadedmic Awards Have you ever been suspended or dismissed from any college/university? q Yes q No If yes, please describe contact and employer information 1. Current Employer Telephone Address Position From To 2. Previous Employer Telephone Address Position From To

5 survey Wilmington University wants to help you achieve your educational goals. Your answers to this survey will assist us in understanding our students and their needs and will be kept confidential. Thank you for taking the time to complete this survey. What is your reason for choosing Wilmington University? q Location q Cost/Affordability q Programs q Other Has either your mother or father completed a four-year college (bachelor s) degree? q Yes q No How many hours per week do you plan to work while attending Wilmington University? q None q 1-10 q q q q 41 or more Do you plan on earning a degree at Wilmington University? q Yes q No If you do not plan to earn a degree at Wilmington University, please indicate if you are taking courses for: q Transfer to another institution q Personal interest/enrichment q Career exploration q Specific career-related skills or knowledge q Other Of all the colleges you considered, would you describe Wilmington University as your: q 1st choice q 2nd choice q 3rd choice q 4th choice or lower What type of school did you attend most recently before entering Wilmington University? q High School q Vocational/Technical School q Other q 2-Year College q 4-Year College or University How do you plan on funding your education at Wilmington University? (Check all that apply.) q Parents/Family q Employer tuition remission q Scholarships q Student Loans (Perkins, Federal Direct, etc.) q Other Loans Which of the following factors influenced your decision to apply to Wilmington University? (Check all that apply.) q Academic reputation of the University q Cost q Availability of my major q Availability of financial aid q Location q Advice of parents or relatives q Size q Advice of high school counselors or teachers q Open admissions q Contact with University representatives q Advice of someone who attends (or attended) the University q Employment q Personal Savings q Spouse s Income q Social Security Benefits q Veteran s Benefits How did you first learn about Wilmington University? (Check all that apply.) q Friend/Relative q Guidance Counselor q College Fair or Event q Letter in the Mail q Advertisement q Other q Alumni q Recruiter q q Internet Search q Billboard q Print Ad q Television Ad q Online Ad q Radio Ad

6 next steps 1 Submit your WilmU Application for Graduate Admission, including statement of goals, completed and signed, along with the $35 application fee to the Admissions/ site office. I understand that in the course of my association with Wilmington University, I will be given the opportunity to participate in many college activities, including practicum, internships, field trips and special events. I hereby agree to assume all risks of injury, loss or damage to my person or property, while engaged in the aforementioned activities or in going to or returning from same. I understand that Wilmington University has the authority to withdraw my privilege of admission, enrollment, and/or graduation for academic, disciplinary, legal or other reasons deemed sufficient ? Mail to: Graduate Admissions 31 Reads Way New Castle, DE Have official transcripts from all previously attended regionally accredited institutions of higher education sent directly from the institution to the Graduate Admissions Office at the address above. Applicants for the Doctor of Business Administration, Doctor of Education, Doctor of Nursing Practice, M.S. in Clinical Mental Health Counseling, and M.S. in Nursing programs must submit recommendations before consideration for admission. Interview or attend a Program Planning Conference with a Graduate Admissions Associate or Faculty Coordinator. Complete a writing sample, as defined by the appropriate academic department. Questions? Contact the Office of Graduate Admissions at (302) 356-INFO (4636). I understand that inappropriate, harmful, and/or illegal activity is not permitted on the premises of Wilmington University. I give Wilmington University permission to define such behavior. Such behavior will be addressed at the discretion of Wilmington University and, if deemed necessary, be reported to legal authorities, employers, and/or professional organizations. I understand that this type of behavior may result in immediate expulsion. In accordance with the Family Educational Rights and Privacy Act, students have the following rights: 1) Right to inspect and review student s record; 2) Right to seek amendments to record; 3) Right to consent to disclosure; and 4) Right to file a complaint. These four rights are fully defined in the University catalog and/or on the University website. Wilmington University is authorized to disclose student information without consent when information is designated as Directory Information in the following situations: to school officials with legitimate educational interest; to an alleged victim of a crime of violence; to officials of another institution where students seek to enroll; when Comptroller General of the United States, Secretary of Education, and/or state or local educational authorities requests student information; in connection with financial aid for which student has applied; to accrediting agencies; to comply with judicial order or subpoena; and in connection with a health or safety emergency. For a complete list of the items that are considered Directory Information please consult the University catalog or the University website. Please note that all applicants for the College of Education, if accepted, will be required, pursuant to Delaware law, to submit to a federal and state criminal background check and a Child Protection (Abuse) Registry check prior to any student teaching placement. Negative or adverse criminal history or listing on any such registry may cause the student to be denied a student teaching placement. A student teaching placement is one of the necessary requirements for an Education Certificate. Your agreement to this application acknowledges that you are aware of and understand this condition. We, the signatories to this application, understand the financial obligations associated with the admission to and enrollment in Wilmington University and assume responsibility for full payment of all fees. We understand the University s withdrawal and refunds policy. I have enclosed the required non-refundable application fee of $35. I agree and authorize Wilmington University to publish, for public relations purposes, any photograph(s) in which I appear. I agree that all of the information provided above has been answered fully and correctly. Omission or falsification of information may be grounds for dismissal. Date Applicant s Signature Parent/Guardian Signature (if applicant is a minor) wilmu.edu 6/12

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